Veterinary services are animal-related services rendered to the public and according to Smith, can be split into four categories (2001:188): ‘clinical (treatment of diseased animals and control of production
limiting disorders); preventive (avoiding the outbreak diseases); provision of drugs, vaccines, and other products; and human health protection (inspection of marketed animal products).’ In this thesis, the
veterinary services also encompass the people who deliver these services and their organisation in institutions. In this section, I focus on the main historical events that shaped the veterinary services’ institutional structures as it existed in 2014.31
30 In this thesis, I refer both to the ‘VSD’ and the ‘veterinary services’. The distinction lies in that ‘veterinary
services’ is a broader term than is VSD. The VSD stands for the public veterinary institution in Ghana and veterinary services stand for general animal health services offered to the public by official government vets as well as the private sector, and even more informal practitioners (the latter are discussed in Chapter Three).
31 As mentioned in Chapter One, my fieldwork lasted until February 2015. However, in discussing the official
30
Ghana became the first country in West Africa to establish veterinary services at the beginning of the twentieth century. Oppong is one of the rare authors who has written about this history and his writing reveals that the veterinary department had never completely existed on its own, as a sector, and rather, started off as closely linked to the human health sector. Interestingly, Mr Beal, the first veterinarian sent by the British Empire in May 1909 by boat, came to work within the Medical Department. Mr Beal was supervised by the Principal Medical Officer in Accra and had a medical dispenser for a technical assistant. He and his assistant took care of horses and travelled around the country to conduct a livestock census to describe and characterise species and to carry out disease investigation (Oppong, 1999).
Animal health was clearly a concern of the human Medical Department which, even after Mr Beal left the country during the First World War (1914-1918), continued to investigate animal diseases – especially in the northern parts of the country, where the bulk of the country’s cattle were. For instance, during Mr Beal’s absence, a medical doctor named Dr Le Fanu, was sent to investigate Rinderpest epizootics which were killing cattle on a massive scale. After Mr Beal returned from the war, the British governorate decided on the full establishment of a veterinary department in order to expand veterinary activities. This was done in 1920 through the recruitment of more staff, independence from the Medical Department, and the establishment of the Government Veterinary headquarters in Tamale (Northern Ghana).32
In the years which followed, the veterinary department wavered back and forth from being tightly linked with the agricultural sector through animal husbandry to being quite detached from it. In 1920, before leaving Ghana, Mr Beal wrote a report which contained unprecedented data on the livestock industry in the country and key recommendations for legislation and policy on animal health as well as veterinary activities (Oppong, 1999). Oppong (1999) sees this report – with its aims to develop Ghana’s livestock resources into a key industry – as the foundation of the Veterinary Department. Because there was no other government organisation responsible for livestock improvement in the 1920s, the Veterinary Department integrated animal husbandry into its mission, alongside animal medicine.
January 2015 (the reversion to a centralised VSD in districts and regions, as described later in this chapter), and my participants had not yet understood or experienced the consequences of this.
Following Ghana’s independence in 1957, the Veterinary Department, under the name of the Department of Animal Health, was positioned within the Ministry of Animal Husbandry in 1965. Oppong (1999) described the creation of the Department of Animal Health in 1966 as directly linked to the livestock sub-sector:
Cattle owners were crop farmers and not livestock farmers; animal husbandry practices, including feeding, animal breeding and housing were inappropriate; the local animals were small and (seemed) stunted; Rinderpest and CBPP33 were killing animals in large numbers; there was the
urgency to cut down the importation of livestock, which not only drained resources but also introduced diseases in the country; and there was the need at the same time to supply meat to the population and therefore the desirability to accelerate increase [sic] in livestock numbers
(Oppong, 1999:116-117).
A year later, however, the Ministry of Animal Husbandry disappeared following the coup d’état and the Department of Animal Health was housed in the Ministry of Food and Agriculture (MoFA). This time, animal production was not seen as its function, as this was undertaken by a separate Animal Production Department. The two separate departments merged again in 1987 into the Animal Health and Production Department. In 1995, the department was split yet again into two: the Animal Production Department (APD) and the Veterinary Services Department (VSD). Two decades later, at the time of my fieldwork, I sensed that my participants regretted that animal health and animal production had become two separate institutional elements.#48 34 In 2015, even though it was not an official duty, vets still contributed to animal production and productivity in ways that went beyond health care for these animals, which I discuss further in Chapter Four.35
Vets’ continued role in livestock production in practice has created frictions between the APD and the VSD. An FAO coordinator reported to me that Ghana was an exception in that APD and VSD were separate departments, and was in this way, unlike most other countries. He asserted that representatives of the two departments tended to claim that issues such as livestock feed or diseases
33 Two major cattle diseases. Rinderpest was eradicated in 2011 (globally) but CBPP (Contagious bovine
pleuropneumonia) remained enzootic in Ghana in 2015.
34 The symbol # followed by a number refers to the source of evidence I use in the text (i.e. from an interview
or observation). Each number corresponds to an entry in the table in Appendix A, where I describe all my encounters with participants during fieldwork with respect to anonymity.
35 The difference in remit between the two departments (VSD/APD) was not very clear to me during fieldwork.
My understanding, according to the MoFA website (mofa.gov.gh) and discussions with vets, was that animal production agents had a similar goal as vets, except that they contributed to livestock industry through all possible ways except animal health which was the focus of the vets (at least officially).
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were their domain and both departments wanted to ‘be in charge’ officially, as this enabled them to have a mandate on the ground. One of the district vets I talked to also mentioned this dispute asserting that the APD tried to ‘take livestock feed and insemination [responsibilities] from [the VSD]’ so that the APD could ‘escape’ from being decentralised as those responsibilities required national management.#28
These tensions were also noted in official reports. For example, an expert from the OIE condemned the separation of livestock production and animal health into ‘two disparate Departments’ as this impedes the capacity to strive towards a livestock development policy (Daborn, 2008:1). Similarly, Oppong (1999:150) talked about the ‘unhealthy rivalry and bickering’ between the two departments, which, in addition to ‘the lack of constant policy, […] the lack of resources, frequent changes of
Ministers of Agriculture, undue political interference […] and constant restructuring of the organisational command’, impeded the improvement of livestock husbandry and livestock growth
prior to 1999. All of this suggests that animal husbandry had emerged as a natural veterinary function and its institutional separation from animal health was, therefore, a hotly debated question.
The VSD, under the remit of MoFA, also represented a challenge to vets obtaining the resources they felt were needed. In the 1980s, the International Monetary Fund and the World Bank promoted Structural Adjustment Policies (SAPs) aiming to correct government failures to deliver goods and services efficiently to citizens, by enhancing the role of the private sector and markets and shrinking the public sector in developing countries (Amankwah et al., 2014). In Ghana, according to several respondents, the two main reforms under the SAPs, decentralisation and privatisation, were slowly implemented in the late nineties and had a tremendous impact on how veterinary services operated in the 2000s.#21,#23,#81
Decentralisation entailed the transfer of administrative responsibility, fiscal resources, and political authority from central government agencies to subnational government entities, non-governmental organizations or to the private sector (Robinson, 2007 in Amankwah, 2014). In Ghana, the decentralisation process of MoFA resulted in the local (district) units of the veterinary services being placed under the Ministry of Local Government.
At the same time, the public agricultural services (which included the veterinary services) were affected by the Unified Extension System (UES) set up in 1992 (Asuming-Brempong et al., 2006, MoFA, 2004). The UES positioned the veterinary services alongside other agricultural services such as ‘crops’,
‘extension’ and ‘animal production’ at the regional and district levels. The decentralisation of MoFA aimed to ‘empower the districts to plan and implement their own agricultural extension activities’ (Asuming-Brempong et al., 2006:8). The ‘extension initiative […] was set up and implemented to help
(i) improve efficiency in the management and delivery of extension services, (ii) improve the relevance of technologies available to farmers, and (iii) strengthen the technical departments of MoFA’
(Asuming-Brempong et al., 2006:14).
The decentralisation and the UES together resulted in the fact that, at the district level, financial and material resources allocated to veterinary units no longer came from the central veterinary services (VSD), but from District Directors of MoFA, and from a pool which was shared with other local MoFA units. Money, given to district clinic staff members (whether they were surgeons or technicians), was to cover the following: 1) staff salaries; 2) funds for the clinics’ basic needs (mainly covering vets’ displacement expenses: 300 Ghana Cedis (GHc)36 for surgeons and 150 for technicians per quarter
for each staff member); and 3) some ‘extra’ money for surveillance and prevention campaigns (around 800GC) that some vets have called ‘special activities’.#27,#61
However, funding for ‘special activities’ had stopped being officially mandated at the time of my fieldwork. Ahwoi (2010) has remarked that financial resources allocated to local governments from national budgets have been ‘inadequate’ and that this has put pressure on district directors to allocate funds to units in immediate need or which are managing crises. Thus, surveillance and prevention campaigns related to animal diseases – being considered ‘extra’ – do not receive priority for funding. In addition, in the region examined in this study, field vets also complained that their displacement fees were no longer paid.#48,#49 As a result, by the end of 2014, according to my participants, the funding provided to district vet clinics had become so minimal that government vets often struggled to find the necessary finances to support their clinics’ basic operations and were often forced to use their own salaries for many clinic-related expenses (I discuss this further in Chapter Four).
The privatisation reform involved the ‘transfer of power, resources, and functions from government to
the private sector, non-governmental organizations, and civil society’ (Amankwah et al., 2014). Before
the privatisation process, like in many West-African countries, Ghana’s veterinary services were
34
entirely public (ibid). The intention behind the privatisation reforms was to encourage veterinary practitioners to enter private practice to deliver private services37 where they would also undertake
some public services such as surveillance and prevention campaigns (ibid). Oppong (1999) regarded privatisation as having been inevitable for the veterinary services in Ghana because of simultaneous increases in the number of heads of livestock in the country and decreases in national resources for the provision of free veterinary care.
While none of my participants opposed the privatisation of some veterinary services, many regretted that the reforms came with negative unintended consequences. One senior veterinary technician#71 reported that public vets such as himself expected privatisation to improve the image of the veterinary profession in the eyes of the public and that this would lead the Ministry of Finance to allocate more money to the VSD. This has not happened, although some private vets do possess high- level equipment which allows them to undertake sophisticated animal examinations and to diagnose disease very efficiently.38 There were very few private vets remaining at the time of my enquiry,39
which explains, in part, the poor effect of private vets on improving the profession’s status.
The privatisation process was accompanied by Cost Recovery Programmes and drug liberalisation policies which posed risks to the veterinary services. These programmes and policies introduced charges that farmers and pet owners had to pay directly to their veterinarians in exchange for animal health services or drug administration. Turkson (2003) has argued that, although these changes were supposed to improve access to veterinary services for the general public, given limited resources, they also affected the quality of services actually delivered. Turkson also warned that drug liberalisation could lead to the introduction of bad quality or ‘fake’ drugs and thus encourage farmers’ use of informal practitioners (see more on this in Chapter Five) to treat animals, which could, in turn, lead to disease spread and drug resistance in animal and human populations. The effects of these policies were still being felt in 2015. A senior lecturer at a veterinary school asserted that, because of drug liberalisation and informal practitioners, private vet practice was only really viable in Ghana’s urban
37 Clinical services (mainly pet care) is considered as a private service when there is no public health stake
(Amankwah et al., 2014).
38 For example, I visited a private vet in Accra#26 who had a rapid test for rabies done on dog saliva, whereas
the laboratory at the VSD HQ was at the time, still waiting to receive necessary chemicals from abroad which would allow them to do this type of test.#5
39 In 2011, they were only 18 private vets (Diop et al, 2012) and this number did not seem to have gone up by
areas.#76 In 2014, private veterinary clinics were concentrated in big cities like Accra and Kumasi and focused on companion animals. Veterinary experts talked about a ‘failure’ to privatise the Ghanaian veterinary services: ‘Planned privatisation initiatives […] did not as intended, fill the vacuum created
by the withdrawal of Public VS [veterinary services]’ (Daborn, 2008:2).
All my participants agreed that neoliberal reforms had had dramatic consequences on the veterinary services as a public body. Amankwah et al. (2014) argue that the effects of ‘the transformations of the
formal and informal institutions resulting from decentralisation and privatisation’ have been
underestimated. In Ghana, public investments in construction, equipment and vehicles for the veterinary services had fallen to zero by 1997 and salaries have been drastically reduced (Amankwah et al., 2014).
A consequence of this has been that exhaustive livestock censuses are no longer carried out, the last one having been in 1996.#13 Since this date, estimations have been produced on the basis of expected growth rates of different livestock species. A senior vet working at the VSD headquarters (VSD HQ) was convinced that these estimated numbers did not reflect reality and that they probably largely underestimated the number of livestock heads, and thereby hindered the appropriate release of vaccines and other key resources.
The success of vaccination in humans and animals depends in part on the proportion of the subjects vaccinated; only being able to vaccinate part of a population can render the vaccination effort less efficient in eliminating or preventing a disease (Andre et al., 2008). The limited capacity to vaccinate a major portion of the national cattle herd against anthrax in Ghana has been identified as a problem for the prevention and elimination of the disease (Kracalik et al., 2017). In 2015, the vets I spoke with expressed concern that too few vaccines, for anthrax or otherwise, were being delivered to field vets, and they worried of a failure to deliver sufficient coverage that could prevent important animal diseases.
A former director of the VSD asserted to me that, in 2008, the VSD had received funding for a poultry census. However, this was an isolated event and happened only in reaction to the 2007 outbreaks of AI, and other species of livestock (goats, sheep, and cattle) were not included in this census. Vets advocated for another livestock census in 2013, as one was being planned for crops for the year
36
2014.40 I, however, found no evidence that their request had been taken into consideration at the
ministry level during my fieldwork and no such survey had been conducted in 2014.
As suggested earlier, disease surveillance and country-wide preventive vaccination were significantly undermined by structural adjustment. Although national vaccination campaigns against animal diseases with public health or economic relevance – essentially rabies in pets, PPR in small ruminants, anthrax in cattle and Newcastle disease in poultry – were at the centre of veterinary interventions before the reforms (Amankwah et al., 2014), by 2001, the procurement of vaccines had become seriously affected by delays in access to government funding. Prior to reforms, teams of veterinary technicians would organise annual mass campaigns in villages. By 2014/15 however, this occurred only on an ad-hoc basis in communities touched by serious disease outbreaks and where emergency control was required (Amankwah et al., 2014). In other words, the VSD had to shift from privileging prevention to a focus on disease control.
Reductions in prevention efforts lead to resurgences of serious diseases such as PPR or rabies. Amankwah et al. (2014) reported a significant increase in mortality of sheep and goats due to the lack of vaccination against PPR following reforms. These negative impacts continue to be felt by vets in Ghana. A district vet #59 told me, for example, that she tried to convince farmers to vaccinate every year against PPR as this would benefit them financially, but they usually refused on the basis it was too difficult to organise such events on their own.41 A lecturer of veterinary medicine mentioned that
free annual rabies vaccination campaigns ceased in 1996, just as decentralisation began.#81 This had immediate impacts as while more than 12 million dogs were vaccinated against rabies in 1994 and 1995 respectively, only 6 million were vaccinated in 1996 (Oppong, 1999). According to a senior vet, despite attempts by the VSD to bypass usual government routes and use private traders to import vaccines, this was ‘unsustainable’.
Furthermore, the numbers of public technical veterinary staff (doctors as well as technicians) were reduced by ‘ending the automatic employment of graduates’ and ‘retrenching veterinary [low grade technicians]’ (Amankwah et al., 2014:303). More than one thousand Community Animal Health Workers (CAHWs) had been trained between 1995 and 2000 with international funding. They were selected by their communities, and were supervised and provided with kits and annual licenses by
40 This comes from a statement about the need for livestock census made in the VSD annual report for MoFA
and the year 2013.
the VSD (ibid). These CAHWs also participated in private sector activities since they collected money directly from farmers after having delivered basic animal healthcare services. On this issue, vets reported that some CAHWs went beyond their official remit and ‘provided injections and even
engaged in surgeries’, which discouraged vets from supporting and training CAHWs (Amankwah et al.,
2014:304). As a result, the CAHW scheme collapsed in Southern Ghana and district vets were charged with responsibility for wider areas. In 2014/15, I did not meet or hear of any CAHWs during my fieldwork. Structural adjustment has also made it harder to get an education to be a vet doctor as the